Episode 7 | Ask the Expert | Guest: Maddie Tait BSc, MSc – Sports MSK Podiatrist, LBSM
If you have ever been referred for a gait analysis and had no idea what to expect, you are not alone. Podiatry – and particularly its sports and musculoskeletal side – is one of the lesser-known clinical specialties, even among people who are regularly active. Yet for a significant proportion of lower limb injuries, understanding how someone moves is the key to understanding why they keep getting hurt.
In this episode of the London Bridge Sports Medicine podcast, Dr Ajai Seth is joined by Maddie Tait, LBSM’s Sports MSK Podiatrist, for a clear explanation of what gait and biomechanical assessment actually involves – and who stands to benefit from one.
What is musculoskeletal podiatry?
Most people’s experience of podiatry is chiropody: the treatment of corns, calluses, nail problems, and routine foot care. Musculoskeletal podiatry is a distinct specialism within the field, focused on how the feet and ankles function in relation to the rest of the body – the knees, hips, and back – and how biomechanical factors contribute to pain and injury.
The two areas are more connected than they might appear. A callus or corn has a cause, and that cause is often biomechanical – a localised area of excessive pressure or loading resulting from how the foot is moving. But musculoskeletal podiatry also extends well beyond foot complaints. Problems in the knee, hip, and lower back frequently have a foot or gait component that, if unaddressed, means the injury keeps recurring even when the acute symptoms have been treated.
As Dr Seth explains: “We can treat the injury in the acute setting, but trying to make sure it doesn’t come back requires some input. That’s often where podiatry and sports medicine work together well.”
What does a gait assessment involve?
A full biomechanical and gait assessment with Maddie typically includes the following:
History and symptom discussion
A detailed conversation about the presenting complaint: what the symptoms are, what makes them worse, which footwear aggravates or helps, how and when the problem developed. The aim is to understand the injury before assessing the movement.
Static biomechanical assessment
Assessment of the muscles and joints both statically and on the treatment couch: the quality and range of movement at each joint, areas of strength and weakness, and how these might relate to the presenting symptoms.
Video gait analysis
The patient is filmed walking – from behind, side-on, and frontally – and then running on a treadmill. Slow-motion video reveals movement patterns that are invisible to the naked eye in real time: how the foot strikes the ground, how the ankle, knee, and hip are tracking, whether movement is symmetrical, and where load is being concentrated.
Where possible, Maddie assesses athletes in more than one pair of shoes – for example, a race shoe and an everyday training shoe – as different footwear can produce meaningfully different movement patterns.
Management plan
From the combined picture, Maddie develops a management plan. This might include:
- Custom foot orthotics – insoles made from a mould or scan of the patient’s foot, prescribed to modify the forces and function of the foot during movement. These take approximately three weeks to produce and are fitted and adjusted in clinic.
- Temporary orthotics – off-the-shelf insoles used while custom ones are being made, or for patients who don’t require a custom solution
- Footwear advice – guidance on the most appropriate shoe type for the individual’s foot shape, activity, and biomechanics
- Strapping and padding – temporary measures to offload specific areas or support particular structures
- Toe props and spacing devices – small interventions for forefoot issues
- Exercise prescription – targeted strengthening or flexibility work for the foot, ankle, hip, or lower limb
Can you assess your own gait at home?
To a degree, yes. Maddie notes that a smartphone camera is sufficient to capture useful footage of walking and running gait, and that she has successfully conducted remote video consultations – developed during the pandemic – where patients film themselves walking and running and send the footage in before a video appointment.
For a basic self-assessment, she recommends:
- Film yourself walking both towards and away from the camera, barefoot and in trainers
- Note whether movement appears symmetrical side to side
- Observe foot position at heel strike and toe-off
- Check the wear pattern on old running shoes – uneven wear is a useful indicator of loading asymmetry
This kind of self-observation has value, but interpreting what you see is the skill – and that is where clinical expertise matters. Maddie’s note of caution on running shop gait analysis: it can be a helpful starting point but tends to oversimplify, categorising people by foot type in ways that do not always reflect individual biomechanics.
Who would benefit from a gait assessment?
A biomechanical assessment is worth considering for:
- Anyone with a recurring lower limb injury (knee, hip, shin, foot, ankle) that keeps coming back despite treatment
- Runners who are increasing mileage and want to reduce injury risk proactively
- Anyone who notices a persistent niggle on one side – particularly after activity – that doesn’t have an obvious explanation
- People who have changed their footwear or activity level and developed new symptoms
- Anyone whose lower limb injury is being treated medically but where a biomechanical cause has not been explored
The bottom line
Lower limb injuries rarely exist in isolation from how the foot is functioning. A treatment that addresses the injury but not the movement pattern that caused it is often a temporary fix. Gait and biomechanical assessment adds the missing layer – understanding not just what is injured but why – and that understanding is often what breaks the cycle of recurring problems.
“Listen to your body,” says Maddie. “Don’t just ignore pain – do listen to it. It could be something that could be simply addressed with a change in footwear or an intervention like orthotics. And that might be it for you.”
Maddie Tait (BSc, MSc) is LBSM’s Sports MSK Podiatrist, specialising in gait analysis, biomechanical assessment, and lower limb injury management. She sees patients across LBSM’s London clinic sites and offers remote video consultation for those unable to attend in person.
To book an appointment with Maddie or another member of the LBSM team, visit lbsm.co.uk/booking
Listen to the full episode below ↓
